Low health literacy translates to poor medication adherence for hypertensive Hispanics

A study of more than 1,000 Hispanic adults with hypertension found increased health literacy improves patients’ adherence to blood pressure medications—but the majority of the population struggles with poor health literacy, indicating a need for tailored interventions.

The NYU Rory Meyers College of Nursing and Columbia University School of Nursing partnered for the research, which was published Jan. 3 in the Journal of Racial and Ethnic Health Disparities. Senior author Ann-Margaret Navarra, PhD, and colleagues conducted a cross-sectional survey of Hispanics with self-reported hypertension, adjusting for covariates like sociodemographic characteristics, depression, anxiety and poor sleep.

Navarra, an assistant professor at NYU Meyers, noted high blood pressure is a major driver of CVD in Hispanic individuals, who make up the largest racial and ethnic minority population in the U.S.

“Adherence to prescribed antihypertensives is an essential component of modifying the devastating risks of untreated hypertension,” she said in a release.

The researchers surveyed 1,355 subjects, the majority of whom were born in the Dominican Republic, and created linear regression models for health literacy, each covariate and medication adherence. They found 88.4 percent of participants had low levels of adherence to their blood pressure drugs—a number that correlated with an 84.9 percent incidence of inadequate health literacy.

“Our study suggests that a number of factors—including health literacy, sex, age and sleep—should be considered when developing meaningful interventions to increase Hispanics’ adherence to medication for high blood pressure,” Maichou Lor, PhD, a co-author from Columbia Nursing, said in the release. “While more research is needed to further identify and prioritize these factors, a tailored approach could support medication adherence and therefore improve hypertension outcomes of Hispanics.”

The authors said some disparities in the results were clear, like those between sexes and ages. For instance, men were more likely to take their blood pressure meds as prescribed, and antihypertensive adherence decreased with age. But the researchers’ full model explained just 13.6 percent of the variance in medication adherence.

“When considering health literacy, for example, it is important to assess a patient’s understanding of the dose and the purpose of the antihypertensive, and use visual aids for individuals with low health literacy,” Navarra said. “However, it is equally important to ask about other modifiable factors for suboptimal adherence, including sleep disturbances and mental health issues, as we found these variables to be associated with lower antihypertensive levels.”